The forgotten role of lymphangitis in Crohn's disease

Kruiningen, H J Van; Colombel, Jean-Frédéric
January 2008
Gut;Jan2008, Vol. 57 Issue 1, p1
Academic Journal
Research into Crohn's disease has recently been focused on the genetics of the patient, the gastrointestinal flora, the gut epithelium and mucosal immune responses. For over 60 years pathologists have reported that the fundamental alteration in Crohn's disease occurs in regional lymphatics of the intestine—the disease is a lymphocytic and granulomatous lymphangitis. At an earlier time, experimental sclerosis of regional intestinal lymphatics of the pig produced a chronic segmental enteritis with many features of Crohn's disease, including lymphocytic and granulomatous lymphangitis of the bowel wall and enteroenteric and enterocutaneous fistulas. In Crohn's disease, differences in the anatomic distribution of vasa recta appear to explain long-segment disease of the ileum and short-segment disease of the more proximal intestine. A variety of bacteria and viruses cause Iymphangitis, suggesting that microorganisms may be at the centre of the basic changes in Crohn's disease. Dietary antigens and lipids are worthy of consideration as well. Now that antibodies to label lymphatics are available, attention should be directed at defining the initial damage to lymphatic endothelium and agents that might be responsible.


Related Articles

  • THE CD40/CD40L COSTIMULATORYU PATHWAY IN INFLAMMATORY BOWEL DISEASE. Danese, S.; Sans, M.; Fiocchi, C. // Gut;Jul2004, Vol. 53 Issue 7, p1035 

    The complexity of inflammatory bowel disease is well recognized at both the clinical and therapeutic levels. Even more complex however appears to be the unraveling of its aetiology and pathogenesis where environmental, genetic, bacterial, and immune factors come together to generate the clinical...

  • Mucosal T-cell immunoregulation varies in early and late inflammatory bowel disease. Kugathasan, S.; Saubermann, L. J.; Smith, L.; Kou, D.; Itoh, J.; Binion, D. C.; Levine, A. D.; Blumberg, R. S.; Fiocchi, C. // Gut;Dec2007, Vol. 56 Issue 12, p1696 

    Background and aims: Crohn's disease is a life-long form of inflammatory bowel disease (IBD) mediated by mucosal immune abnormalities. Understanding of the pathogenesis is limited because it is based on data from adults with chronic Crohn's disease. We investigated mucosal T-cell...

  • The ATG16L1 Gene Variants rs2241879 and rs2241880 (T300A) Are Strongly Associated With Susceptibility to Crohn's Disease in the German Population. Glas, Jürgen; Konrad, Astrid; Schmechel, Silke; Dambacher, Julia; Seiderer, Julia; Schroff, Frieder; Wetzke, Martin; Roeske, Darina; Török, Helga-Paula; Tonenchi, Laurian; Pfennig, Simone; Haller, Dirk; Griga, Thomas; Klein, Wolfram; Epplen, Jörg T.; Folwaczny, Christian; Lohse, Peter; Göke, Burkhard; Ochsenkühn, Thomas; Mussack, Thomas // American Journal of Gastroenterology;Mar2008, Vol. 103 Issue 3, p682 

    OBJECTIVES: We analyzed ATG16L1, a recently identified Crohn's disease (CD) susceptibility gene, in a large cohort with inflammatory bowel disease (IBD) including potential interactions with other IBD genes as well as factors regulating its gene expression. METHODS: Genomic DNA from 2,890...

  • Does innate immune response defect underlie inflammatory bowel disease in the Asian population? Lanzarolto, F.; Akbar, A.; Ghosh, S. // Postgraduate Medical Journal;Aug2005, Vol. 81 Issue 958, p483 

    Reports that lifestyle rather than key genetic defects might be responsible for the defective innate immune response in Asians with inflammatory bowel disease (IBD). Evolution of the mucosal immune system to balance the need to respond to pathogens while maintaining active tolerance to commensal...

  • Inflammatory bowel disease. Johnson, Heather // Practice Nurse;4/6/2007, Vol. 33 Issue 7, p35 

    This article offers facts about inflammatory bowel disease (IBD). The main forms of inflammatory bowel disease are ulcerative colitis and Crohn's disease. These chronic conditions of the gastrointestinal tract cause a range of humiliating and often painful symptoms, the severity of which depends...

  • Recent Approaches in Pathogenesis of Inflammatory Bowel Disease. Solanki, Roshni; Madat, Dhaval; Chauhan, Khushbu; Parmar, Lalkrushn // International Journal of PharmTech Research;Jul-Sep2010, Vol. 2 Issue 3, p1796 

    Inflammatory bowel disease (IBD) commonly refers to ulcerative colitis (UC) and Crohn disease (CD), which are chronic inflammatory diseases of the GI tract of unknown etiology. This inflammatory response is most likely made possible by defects in both the mucosal immune system and the barrier...

  • Between vigilance and tolerance: the immune function of the intestinal epithelium. Chassin, Cécilia; Hornef, Mathias // Cellular & Molecular Life Sciences;Nov2011, Vol. 68 Issue 22, p3619 

    No abstract available.

  • TOLL LIKE RECEPTORS 2 AND 4 UPREGULATED ON HUMAN LAMINA PROPRIA DENDRITIC CELLS IN INTESTINAL INFLAMMATION. Hart, A. L.; Al-Hassi, H. O.; Kamm, M. A.; Knight, S. C.; Stagg, A. J. // Gut;Apr2004 Supplement 3, Vol. 53, pA3 

    Dendritic cells (DC) are antigen presenting cells present in the intestinal tract that sample microbial products within the gut lumen and play a central role in linking innate and adaptive immunity. Recognition of microbes by DC is in part by toll like receptors (TLR). Authors assessed the...

  • Trichuris suis seems to be safe and possibly effective in the treatment of inflammatory bowel disease. Summers, Robert W.; Elliott, David E.; Qadir, Khurram; Urban Jr., Joseph F.; Thompson, Robin; Weinstock, Joel V. // American Journal of Gastroenterology;Sep2003, Vol. 98 Issue 9, p2034 

    : ObjectivesInflammatory bowel disease (IBD), especially Crohn''s disease (CD), probably results from failure to downregulate a chronic Th1 intestinal inflammatory process. Induction of a Th2 immune response by intestinal helminths diminishes Th1 responsiveness. This study evaluates the safety...


Read the Article


Sign out of this library

Other Topics